南方医科大学学报 ›› 2020, Vol. 40 ›› Issue (02): 147-151.doi: 10.12122/j.issn.1673-4254.2020.02.01

• •    下一篇

新型冠状病毒肺炎防控形势下急性心肌梗死诊治流程和路径的中国专家共识(第1版)

卜 军,陈 茂,程晓曙,董一飞,方唯一,葛均波,龚艳君,何 奔,黄 岚,霍 勇,贾绍斌,蒋 峻,李 悦,李 昭,梁 春,刘学波,刘震宇,马 翔,马依彤,钱菊英,沈成兴,沈涤非,沈 雳,石瑞正,苏 晞,孙英贤,唐熠达,王建安,吴 岳,向定成,徐通达,徐亚伟,杨跃进,曾和松,张 澄,张国刚,张瑞岩,张书宁,张 运,张 钲,郑 博,周 宁   

  • 出版日期:2020-03-14 发布日期:2020-02-20
  • 基金资助:

Consensus of Chinese experts on diagnosis and treatment processes of acute myocardial infarction in the context of prevention and control of COVID-19 (first edition)

  

  • Online:2020-03-14 Published:2020-02-20

摘要: 自2019年12月以来,新型冠状病毒肺炎在武汉感染流行并迅速蔓延全国各地,根据国家整体防控方案,绝大部分地区启动限制出入、限制交通等措施。此特殊形势对于急性心肌梗死患者的转运救治流程提出了新的要求。急性心肌梗死发病急、致死性高、最佳救治窗口期短、且容易合并呼吸系统感染及呼吸、循环衰竭,更加需要就地积极治疗。为规范管理、易化流程,现制定急性心肌梗死诊治流程和路径策略,其核心是就近原则、安全防护原则、溶栓优先原则、定点转运原则、远程会诊原则。对于急性心梗患者,应排查新型冠状病毒肺炎,针对发病时间窗,选择不同的治疗策略。在这一特殊时期,包括介入医师在内的心血 管医生都应掌握溶栓的禁忌症和适应证。在急性心肌梗死患者的转运和治疗中,应严格掌握转运及手术指征,严格按照要求对感染者及医务工作者进行防护。

Abstract: The SARS-CoV-2 epidemic starting in Wuhan in December, 2019 has spread rapidly throughout the nation. The control measures to contain the epidemic also produced influences on the transport and treatment process of patients with acute myocardial infarction (AMI), and adjustments in the management of the patients need to be made at this particular time. AMI is characterized by an acute onset with potentially fatal consequence, a short optimal treatment window, and frequent complications including respiratory infections and respiratory and circulatory failure, for which active on-site treatment is essential. To standardize the management and facilitate the diagnosis and treatment, we formulated the guidelines for the procedures and strategies for the diagnosis and treatment of AMI, which highlight 5 Key Principles, namely Nearby treatment, Safety protection, Priority of thrombolysis, Transport to designated hospitals, and Remote consultation. For AMI patients, different treatment strategies are selected based on the screening results of SARS-CoV-2, the time window of STEMI onset, and the vital signs of the patients. During this special period, the cardiologists, including the interventional physicians, should be fully aware of the indications and contraindications of thrombolysis. In the transport and treatment of AMI patients, the physicians should strictly observe the indications for patient transport with appropriate protective measurements of the medical staff.